The objective of this 5-year, Mentored Clinical Scientist Development Award is to develop the skills necessary to become an independent investigator in conducting psychosocial research with alcohol using adolescents treated in Emergency Departments (EDs). Previous research has focused on the prevalence of alcohol and other substance use in relation to injury, timing of injuries, trauma recidivism, and the readiness to change in ED populations. However, the distinction between alcohol use and alcohol use disorders (AUD) in the adolescent population has been virtually ignored. Further, while preliminary efforts are now being made to establish rates of AUDs in ED populations, there is no research being done in adolescent ED populations that addresses the issue of other mental disorder symptomatology and its relationship to injury and illness. There is also a need to develop valid and reliable alcohol screening instruments that can be quickly administered to adolescents in the hectic pace of an ED environment, in order to discriminate social drinkers from actual and potential problem drinkers. Finally, the heavy use of substance and mental health rehabilitation services by adolescents, coupled with high trauma recidivism, suggests that much is being done in the attempt to help adolescents at high-risk for injury, but with little effect. A need exists to begin collecting data on what services are being used and what is effective with this population, if we are to be able to design effective interventions. Dr. Thomas Kelly has successfully coordinated psychiatric research projects at Western Psychiatric Institute and Clinic for over 10 years and has authored or co-authored six journal articles or presentations on psychiatric disorder and self-injury. He is completing a 2-year post- doctoral fellowship in an alcohol research training program at the Pittsburgh Adolescent Alcohol Research Center (PAARC), during which he became a co-investigator on an ongoing pilot study of alcohol use in ED treated adolescents. This award will permit Dr. Kelly to remain at PAARC and develop is skills in: 1) investigators the relationships between substance use and other mental disorders to injury in high-risk adolescents; 2) develop screening instruments for problematic alcohol use with this at-risk population; 3) the methodology of epidemiological research; and 4) investigating health care and social service use in adolescents treated in EDs, as a preliminary step to the design of interventions to reduce substance use and mental disorder co-morbidity in these adolescents.